Last update April 18, 2022
Very Low Risk
Hydrocortisone or cortisol is a natural steroid produced in the adrenal cortex. It has glucocorticoid and, to a lesser extent, mineralocorticoid effects. Its esters are used as topical anti-inflammatories (dermatological, intestinal, ophthalmic and otic).
At the date of the last update we did not find any published data on its excretion in breast milk.
Topical use: The poor absorption through the skin and conjunctiva makes it unlikely that a significant amount will pass into breast milk. Bioavailability through the skin is less than 20% and after retention enema from 50 to 80%. (DrugBank acces.2022)
Furthermore, its pharmacokinetic data (high percentage of protein binding, wide volume of distribution and short half-life) make it highly unlikely that significant quantities will pass into breast milk.
Whenever a treatment for nipple eczema or dermatitis is required, it should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week.
Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple. (De Stefano 1983)
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant. (Concin 2008, Noti 2003)
Eleventh WHO Model List of Essential Drugs 2002: topical use compatible with breastfeeding. (WHO 2002)
We do not have alternatives for Hydrocortisone, Topical Use (dermatological, ophthalmic, otic, intestinal enema) since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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